Review

Best to start close to home

PROMOTING HEALTH: politics and practice
Lee Adams, Mary Amos and James Munro (eds)
Sage, £17.99

At first glance this is a rather daunting albeit slim tome: small print, tightly packed pages, multi-author (but no doctors) and quite a lot of references. Even the cool white, blue and black dustcover is uninviting. For students, rather than busy practitioners, was my initial impression.

But perseverance brought copious fruit. In fact, it unearthed a very interesting melange of descriptive material – in the form of case studies – and more analytical and conceptual pieces covering the broad span of the health and well-being agenda. The latter, however, omitted primary care and crime and public health, two areas of particular personal interest.

As someone with more than 30 years of practice as a foot soldier of public health (dating back to the old local authority dispensation and including the wilderness Thatcher years), I found the most relevant contributions were those by Geof Rayner and Fiona Campbell. Rayner’s focuses on building a UK public health movement and Campbell’s on the role of local authorities.

Why is there no vibrant public health movement in the UK, akin to the consumer and environmental movements? This cannot be for lack of major public health issues to espouse: the growing inequalities in wealth and health and child poverty are two that immediately come to mind.

What better issues could there be to form the backbone of a populist public health movement? The answer is that the UKPHA and kindred organisations represent professionals rather than the public. It is also evident that public health professionals, particularly doctors, are too close to the establishment to be credible protestors.

The remedy that we are hoping to apply in Wales is to attract real people – members of the public – into the public health movement and identify one or two key issues to campaign on actively.

I also have no doubt, even after a stint as an elected member of local government, of the impact that local politics can have on public health. I believe local government has not only the most important contribution to make at local level in promoting health and well-being, but also that this is its central and overarching function.

The problem, however, is to persuade councillors and officials that this is the case and that they cannot hide behind that all too prevalent fiction that health and well-being are primarily NHS responsibilities.

Public health promotion is a political issue and, more specifically, a socialist issue. We may have progressed a little since 1997 but not as far as many of us would have hoped. Perhaps we need, in concert with members of the public, to actively recruit politicians with the right socialist credentials to help us further the health and well-being cause in parliament and in the town halls.

So from Promoting Health: Politics and Practice it is time to promote health through the practice of (socialist) politics.